Abstract
Objectives: Right ventricular myocardial infarction as assessed by various diagnostic methods accompanies inferior wall myocardial infarction in 30% to 50% of patients. Acute right ventricular myocardial infarction is associated with higher in-hospital morbidity and mortality related to life-threatening hemodynamic compromise and arrhythmias. Since there is scarcity of literature regarding epidemiology of clinical profile as well as in-hospital outcomes of patients with right ventricular myocardial infarction in the Indian population, this study is carried out with a goal of identifying the same in our hospital setting, to fulfill this void. Methods: We examined the incidence of risk factors in patients (n = 100) with inferior wall myocardial infarction and 100 patients with inferior wall myocardial infarction having right ventricular involvement. Results: The mortality rate was found to be 12% in patients with inferior wall myocardial infarction and 28% in patients having right ventricular involvement in inferior wall myocardial infarction. Conclusions: From the above study, it can be concluded that patients with inferior wall myocardial infarction who have right ventricular myocardial involvement are at an increased risk of death, and cardiogenic shock.
Highlights
Based on early experiments of right ventricular performance, it was felt for many years that right ventricular contraction was unimportant in the circulation and that, despite loss of right ventricular contraction, pulmonary flow could be generated by a passive gradient from a distended venous system and active right atrial contraction
Recognition of the profound hemodynamic effects of right ventricular systolic dysfunction became evident during the 1970s with the description of severe Right ventricular myocardial infarction (RVMI), resulting in severe right heart failure, clear lungs, and low-output hypotension despite intact global left ventricular systolic function [8]. It has been very well noted in the study that significant RVMI nearly always occurs in association with acute transmural inferior-posterior left ventricular myocardial infarction, and the right coronary artery (RCA) is always the culprit vessel [9] [10], typically a proximal occlusion compromising flow to one or more of the major right ventricular branches
Acute RVMI is associated with higher in-hospital morbidity and mortality related to life-threatening hemodynamic compromise and arrhythmias during acute occlusion and abruptly with reperfusion, complications which have implications for interventional management [11]
Summary
Right ventricular myocardial infarction (RVMI) as assessed by various diagnostic methods accompanies inferior-posterior wall myocardial infarction in 30% to 50% of patients. Recognition of the syndrome of right ventricular involvement is important as it defines a significant clinical entity, which is associated with considerable immediate morbidity and mortality and has a well-delineated set of priorities for its management. Patient may be clinically present with hypotension, elevated jugular venous pulse (JVP), and occasionally shock, all in the presence of clear lung fields [4]. The ST-segment elevation of ≥0.1 mV in the right precordial leads (V4R) of the Electrocardiograph (ECG) is a readily available electrocardiographic sign used for diagnosis of RVMI. ECG has always been the first choice of investigation to detect RVMI.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
